Supplemental Table 1 Modified components and scoring system for adherence to the American Heart Association Diet and Lifestyle Recommendation (AHA-DLR).
Recommendation Non-adherence Intermediate Good adherence
Dietary factors
Fruits (g/d) <100 (0) 100 ~ 199 (3) ≥200 (5)
Vegetables(g/d) <210 (0) 210~350 (3) ≥350 (5)
Variety/w in F&V intake <10 (0) 10-14 (5) ≥15 (10)
Whole grains (% total grains) None (0) <10% (2), 10-25% (5) ≥50% (10)
Fish intake (g/w) Never (0) <200 (3), 200-400 (5) ≥400 (10)
Total fat intake (% energy) >35% (0) <25% (2) 25-35% (4)
Saturated fat intake (% total fat) >7.0% (0) 3.5-7.0% (3) <3.5 (6)
Dietary cholesterol (mg/d) >300 150-300 (2) <150 (4)
Sweetened beverages (oz/w) >36 (0) 24-36 (2), 12-23 (5) ≤12 (10)
Salt intake (g/d) >9 (0) 6-9 (5) <6 (10)
Alcohol intake (drinks/d) ≥2 (0) 0 (5) >0 or <2 (10)
Smoking Current smoking (0) Ever smoking (2) Never smoking (5)
Physical activity Sedentary (0) Moderate (5) Vigorous (10)
The scores for various adherence levels were in parenthesis.
Supplemental Table 2 Associations between subcomponents of the modified AHA recommendations and bone mineral density (g/cm2) at various sites
Scores of subcomponents B coefficients (95% CI)
Whole body BMD Lumber spine BMD Femoral neck BMD
n 3922 3847 3922
Fruits 0.003 (0.001,0.005)* 0.003(0.001, 0.004)* 0.002 (0.000, 0.004) *
Vegetables -0.001 (-0.003, 0.001) -0.001(-0.004, 0.002) -0.001(-0.002, 0.001)
Variety in F&V intake -0.001(-0.002, 0.000) -0.001 (-0.003, 0.000) -0.001(-0.002, 0.000)
Whole grains% 0.001(-0.001, 0.002) 0.002(-0.001, 0.005) 0.000(-0.001, 0.002)
Fish intake 0.000 (0.000, 0.001) 0.001(-0.001, 0.002) 0.000(0.000, 0.001)
Total fat intake (% energy) 0.001(-0.001, 0.003) 0.002(-0.001, 0.005) 0.000 (-0.002, 0.002) Saturated fat intake (% total fat) 0.000(-0.002, 0.002) -0.001(-0.004, 0.002) -0.001(-0.003, 0.001) Dietary cholesterol -0.000(-0.003, 0.002) -0.001(-0.005, 0.003) -0.003(-0.006, -0.001)*
Sweetened beverages -0.001(-0.002, 0.000) -0.002(-0.003, 0.000)* -0.001(-0.001, 0.000) Salt intake -0.001(-0.001, 0.000) -0.002(-0.003, -0.001)* -0.001(-0.002, 0.000)
Alcohol intake 0.000(-0.002, 0.002) 0.001(-0.002, 0.004) 0.000(-0.002, 0.000)
Smoking 0.001(-0.001, 0.003) 0.003(0.000, 0.007) 0.001(-0.001, 0.003)
Physical activity 0.001(0.000, 0.002) 0.002(0.000, 0.003)* 0.001(0.000, 0.002)
B coefficients and 95% CI were calculated by multivariate regression models. * P<0.05; F&V, fruits and vegetables. The adjusted covariates included age, sex, season, education levels, body mass index (BMI), height, dietary total energy, protein , milk products, dietary calcium and vitamin D intake, dietary calcium supplementation (yes or no), sitting and sleeping hours, medical history (yes or no) of diabetes, stoke, hypertension and cancers, medication treatment for osteoporosis (yes or no), total AHA score minus the component being assessed. Lifestyle scores of subcomponents were derived from adherence index based on American Heart Association on dietary and life style recommendations.